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Care Manager/Case Mgr (RN preferred) at CareMore (Anthem, Inc.) Ft. Worth, TX # PS13739 in Fort Worth, TX at Anthem, Inc.

Date Posted: 11/16/2018

Job Snapshot

Job Description

Your Talent. Our Vision. At CareMore, a proud member of the Anthem, Inc. family of companies specializing in providing senior Americans a complete and pro-active health care experience, it’s a powerful combination. It’s the foundation upon which we’re creating greater access to care for our members, greater value for our customers and greater health for our communities. Join us and together we will drive the future of health care.
This is an exceptional opportunity to do innovative work that means more to you and those we serve.

You can learn more about CareMore’s transformative approach to care here:
The Case Manager, CareMore Primary Care utilizes advanced nursing skills and knowledge of resource management to coordinate the clinical care for a designated patient population across the continuum of care. The Case Manager will be engaged in assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs. 
Core Competencies:
  • A true patient-centered approach, that puts patients and caregivers at ease
  • A collaborative team member and effective communicator
  • Willingness to operate in an ambiguous environment, without continuous supervision
Essential Duties and Responsibilities
  • Manages patients across the continuum of care
  • Safely and effectively transitions patients from acute/inpatient care to lower levels of care and/or home in a cost effective manner
  • Provides assessment, planning, implementation, coordination, and monitoring of services for the patients as they transition between care settings
  • Conducts hospital and post-discharge calls
  • Collaborates in a patient care process to assess, plan, facilitate, coordinate, monitor, and evaluate options and services to meet patient’s health needs.
  • Supports patient or their representative in regard to care, care transitions, and changes in health status.
  • Obtains input from providers, patient, and family as appropriate, and evaluates and revises the plan as needed.
  • Transition of care support, prior to and at the time of admissions, to ensure appropriate services are provided that are necessary to facilitate a safe discharge or placement in the appropriate level of care
  • Identifies patients that are high utilizers of resources, in a high risk category or have a condition that is considered high cost and promote cost effective utilization of resources
  • Manages outreach to high risk patients
  • Ensures that data and records area current and appropriately recorded
  • Engages with key community care partners (i.e. hospitals, nursing homes and other facilities) to coordinate care and collaboration needs
  • Participates in Interdisciplinary Care Team meetings
  • Solves complex problems and takes a new perspective on existing solutions; exercises judgment based on the analysis of multiple sources of information
  • May perform skills related to scope of practice
Work location and travel expectations:
Local market with local travel

Minimum Qualifications:
  • Requires a LVN, LPN, or RN with 2 years of experience(hands on clinical setting); or any combination of education and experience, which would provide an equivalent background
  • Current unrestricted LVN, LPN, or RN license in applicable state(s) required
  • Must be willing to do in person visits in a Hospital, SNF or similar, Office/clinic and patient home setting.
  • 3 years of experience working with individuals with chronic illnesses, co-morbidities, and/or disabilities in a Case Management, Service Coordinator, Advocate, Utilization Review or similar role is highly preferred.
  • Bilingual (Spanish) – Preferred.
  • RN preferred
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 Diversity, Inc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.


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